820212_Annual Report_20200408 (2)

ATTACHMENT A
AEG ANMIVMAL FACILITY ANNUAL REPORT FORM
Re i for (pre $us) Calendar Year: 20 / c, Today's Date: 2. c ® ,
E1 �fifice
Certifiet 4roverage or Permit Number , % (i> _? 0. p .-7_i _ County.Ge
..,
Facility Name (as shown on Certificate of Coverage or Permit) 2, ,l`11 C GGL f) Airme,n, L Le -
Operator in Charge for this Facility Z. i .� / . _ A. =Gf .{ ,,,, J . Operator Certification # / 7 -7
Facility's Integrator, if applicable:... PRY S'zs
Part Facilitl Information (As of December 31st of renortin2 Near unless otherwise specifiedd):.
Land _application of animal waste as allowed by the above permit occurred during the past calendar year
YES NO. If NO, skip Part I and proceed to Part II and Part III. Also, if animal waste was
generated but not land applied, attach an. explanation on how the animal waste was managed/disposed.
CAWMP SUMMARY
Total number of application Fields
Management Plan (CAWMP):
or Pulls in the Certified Animal Waste
Fields,, or. ......;
...
/ 9
Pulls/zones
_ _......:. , . _..
Tatal.Useable Acres roved in the CAW/VIP
approved
4 1 • I I
...
Acres
Total pounds of Plant Available Nitrogen (PAN) allowed to be land applied
.. annually by the CAWMP and. the permit:
......_......
/ 6 7 52
Lbs. PAN
LAGOON_ SUMMARY
Number of Permitted Lagoons
#Lagoons
Number of Permitted Lagoons with a sludge removal or management plan
per Permit Condition III-22
0
#Lagoons
ANNUAL OPERATIONS SUMMARY
(for all crops with windows that ended .during the previous. calendar'_year:)
Total number of Fields or Pulls on which land application occurred during
the year
,. Fields .. or
/ 1
Pulls/zones
Total Acres :on which animal waste .
was: applied ..
(� ;. J ..
_.Acres
Total pounds of Plant Available
Nitrogen (PAN) applied during
the year for all application sites:
Permitted Animal Waste
Lbs. PAN
Other Nutrient Sources (incl Dry Litter) '
Lbs. PAN
SOIL. SAMPLE. SUMMARY.,.
Total number of Fields or Pulls for which the most recent soils. evaluation
indicated a Soil P (P-index) greater than 400
Fields or.
Pulls/zones
Total usable acres of Fields or Pulls for which the most recent soils
evaluation indicated a Soil F(F=index):;greater than 400
Acres
AFOAR 4-12-2019

ATTACHMENT A
BENIFICAL USE SUMMARY
Estimated amount of total manure, litter and process wastewater sold or Tons
given to other persons and taken off site during the year
PRODUCTION SUMMARY
Annual average number of animals b+ ftype at this fa 'Way during the'previous`year ... y ..._.
Number of Animal
0
Gallons
Operation Type
Swine Cattle Dry Poultry Other Types
Wean to Finish Dairy Calf Non -Laying Chickens Horses _ Horses
Wean to Feeder Dairy Heifer Laying Chickens Horses — Other
Farrow to Finish Milk Cow Pullets Sheep — Sheep
Feeder to Finish Dry Cow Turkeys. Sheep - Other
Farrow to Wean Beef Stocker Calf Turkey Pullet
Farrow to Feeder Beef Feeder
Boar/Stud Beef Broad Cow Wet Peal
Gilts Other Non -Laying Pullet
Other Layers
Part 11: Facili fr Status, espond ,for, actsvi .within the Calendar. year of ralortimAyearianless.
otherwise.:1i.ecified3:.
Directions: Check box next to the appropriate answer, for each statement were the answer is "No", provide a
written description of any action take taken or pending to address the requirements and return the facility to
compliance
1. All "major changes," "revisions," and "amendments" to the CAWMP were made No
according to requirements of Condition I.4.
2. There were no freeboard exceedances in any lagoons or storage ponds.
3. There was no PAN application to any fields or crops at this facility greater than the
levels specified in this facility's CAWMP.
4. Sludge Surveys as required in Condition HI.22 have been completed.
5. For any temporary lagoon lowering event, drawn down restrictions and record
keeping requirements in Condition II.29 have been met.
6. Soils analysis were performed within the last three years on each field receiving animal
waste.
No
No
No
No
2 AFOAR 4-12-2019

ATTACHMENT A
7. All required monitoring and reporting were performed in accordance with the facility's No
permit during the past calendar year.
S. Crops as specified in the CAWMP were maintained during the past calendar year on all
sites receiving animal waste and the crops grown were harvested and removed in
accordance with the facility's permit.
No
Part III: Affirmation Statement
"I affirm by my signature that this document and all attachments were prepared under my direction or
supervision. The information submitted is, to the best of my knowledge and belief, true, accurate, and
complete. I am aware that there are significant penalties for submitting false information, including the
possibility of civil and criminal penalties."
2. l' J r . i
Permittee Name and Title (type or print)
4
-II/ ,/11 `.- -(-1:177--
Signature of Permittee Date
Signature of operator in Charge
(if different from Pennittee)
.RECEIVED
APR 0 S 2020
NC DEQ/DWR
Central Office
7
Date
3 AFOA1t 4-12-2019